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短期抗炎糖皮质激素治疗对全身健康犬的临床病理、超声心动图和血流动力学变量的影响。

Effects of short-term anti-inflammatory glucocorticoid treatment on clinicopathologic, echocardiographic, and hemodynamic variables in systemically healthy dogs.

作者信息

Masters Allison K, Berger Darren J, Ware Wendy A, Langenfeld Natalie R, Coetzee Johann F, Mochel Jonathan P M, Ward Jessica L

出版信息

Am J Vet Res. 2018 Apr;79(4):411-423. doi: 10.2460/ajvr.79.4.411.

Abstract

OBJECTIVE To investigate mechanisms by which anti-inflammatory doses of orally administered intermediate-acting glucocorticoids (prednisone) could predispose dogs to progression of heart disease or congestive heart failure. ANIMALS 11 client-owned dogs with allergic dermatitis and 11 matched healthy control dogs. PROCEDURES Clinicopathologic, echocardiographic, and hemodynamic variables were measured. Dogs with allergic dermatitis then received prednisone (1 mg/kg, PO) once daily for 14 consecutive days beginning on day 0 (baseline), followed by a tapering and washout period; control dogs received no treatment. Measurements were repeated on days 7, 14, and 35. Linear mixed modeling was used to compare changes in variables across measurement points and between dog groups. RESULTS Prednisone administration caused no significant changes in serum sodium or potassium concentration, blood glucose concentration, or target echocardiographic variables. The change from baseline in systolic arterial blood pressure at day 7 was significantly greater in prednisone-treated dogs than in control dogs. Expected changes in hematologic and serum biochemical values with prednisone administration (neutrophilia, eosinopenia, isosthenuria, and high serum alkaline phosphatase and alanine aminotransferase activities) also occurred in the prednisone-treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that anti-inflammatory doses of orally administered glucocorticoids have the potential to adversely impact cardiac function in dogs by causing an increase in blood pressure and thus increased cardiac afterload.

摘要

目的 研究口服中等效糖皮质激素(泼尼松)的抗炎剂量使犬易患心脏病进展或充血性心力衰竭的机制。动物 11 只患过敏性皮炎的客户拥有犬及 11 只匹配的健康对照犬。方法 测量临床病理、超声心动图和血流动力学变量。患过敏性皮炎的犬从第 0 天(基线)开始连续 14 天每天口服泼尼松(1 mg/kg),随后逐渐减量并停药;对照犬不接受治疗。在第 7、14 和 35 天重复测量。使用线性混合模型比较各测量点及犬组间变量的变化。结果 给予泼尼松未引起血清钠或钾浓度、血糖浓度或目标超声心动图变量的显著变化。在第 7 天,泼尼松治疗的犬收缩期动脉血压相对于基线的变化显著大于对照犬。泼尼松治疗的犬还出现了与给予泼尼松相关的血液学和血清生化值的预期变化(中性粒细胞增多、嗜酸性粒细胞减少、等渗尿以及血清碱性磷酸酶和丙氨酸转氨酶活性升高)。结论及临床意义 研究结果表明,口服糖皮质激素的抗炎剂量可能通过导致血压升高从而增加心脏后负荷,对犬的心脏功能产生不利影响。

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